If you actually do go camping over spring break, your kids may bring home a souvenir you didn't bargain for!

We had Pediatrician Dr. George Bengston tell us what to do about lice, ticks, or worse.

Advice:

Head Lice

Types of lice (slide w/ three types):

1. Body louse
2. Pubic louse "crabs"
3. Head louse

Basic biology:

• Very adaptable creature
• Children affected most commonly
• Spread by interaction w/ playmates and physical transfer from clothing, combs,
• towels, headphones, beds
• Black kids affected less often – no one knows why
• Eggs, attached to hair shafts, are called "nits" (see slide of nit)
• Lice do NOT jump, fly, or travel on pets

Clinical signs

• Itching of scalp, neck, ears due to allergic reaction to louse saliva
• Visualization of lice or nits (see slide of nits on hair)
• Enlarged lymph nodes
• Unexplained skin infections

Diagnosis

• Finding of lice or nits
• Use of nit comb (demonstrate?)
• Nits very near the scalp more suspicious for active infection
• Treatment
• Topical insecticides
• Permethrin (Nix) or Pyrethrins (Rid, A-200, Pronto, Clear)
• Malathion (remember the fruit fly?)
• Lindane (Kwell) – toxicity, especially if left on too long
• Wet combing
• Alternative to insecticides in kids under age 2
• Vinegar or olive oil every three or four days for two weeks after lice found
• Oral agents
• Septra (oral antibiotic) can be used in combination with above insecticides
• Physical agents
• Cetaphil cleanser/"Nuvo lotion" smothers lice? – needs further study
• (Will try to find a bottle of this stuff to show)
• Treatment failures
• Usually due to improper use of product and/or continued exposure
• Genuine resistance is becoming a factor
• Changing from one product to another usually works
• Return to school policies
• "No-nit" policy probably overkill (nits can persist after treatment)
• Schools can respond to outbreaks by segregating hats/coats/etc.
• Household measures
• Examine (but do not necessarily treat) household members
• Treat bunkmates
• Wash clothing, furniture, or carpeting which has been in contact w/ infested head
• Lice do not usually survive more than 48 hours off the host, so bagging/isolating
• bedsheets/pillowcases/stuffed animals/etc can do the trick

TICKS

• Prevention
• Inspection after outdoor adventures
• Removal
• Manual removal w/ tweezers
• "Smothering" type treatments not generally effective

After-care

• Gentle cleansing and observation for signs of infection